As a person with severe mold allergies, I live in a the South where the climate naturally breeds molds.We noticed a difference when we had our ducts cleaned.The company used a vacumn type system and covered all of our vents with plastic that was held up by the suction. We had no damage, no leaking dust/dirt back into the house and it took several hours. I think if you use a reputable company it makes the world of difference. Now we use better air filters and also have a UV light to prevent mold growth on ours system.We 'd do it again when the time comes. From your car's air filter to your dryer...anything works more efficiently when it is not filthy dirty.That's just common sense.
On the other hand, if family members are experiencing unusual or unexplained symptoms or illnesses that you think might be related to your home environment, you should discuss the situation with your doctor. EPA has published the following publications for guidance on identifying possible indoor air quality problems and ways to prevent or fix them.

I just had my blower module replaced because my AC coil was frozen over. The underside of my coils had a thick mat of dust because I had never had it cleaned. I cleaned it myself by using a soft brush attachement on a shop vac. The inside of the blower appears to have a white/green growth, and I am sure the ductwork of my 30 year old house can’t be in good condition.
There are many interesting comments from several informed individuals. The question that has not been answered is how do duct systems get dusty and dirty? As a RESNET Home Energy Rater, I perform pressure tests on homes and duct systems, and the one common thread is . . . most air delivery sytems have large amounts of air leakage. The solution is to seal the duct system, and pay particular attention to the return duct system and ductwork near the air handler (the 'blower'). As others have said, a captive (sealed) duct system with proper filter maintenance should be more then adequate for most occupants. For those who have allergy, asthma, or other breathing problems, a filter with a higher MERV rating (number should be listed on the package) or a HEPA filter are good choices. These filters will capture smaller particulates and should improve the indoor air quality. Again, make certain that the entire duct system is sealed, preferably with mastic, second choice UL-181 foil tape - never use cloth duct (also known as duck) tape.
There is a lot of good, general information in the article. As with anything, the homeowner should do their due diligence in getting enough information to make an educated decision. Should duct-work be cleaned? YES! Does it need to be cleaned annually or even every second or third year? Not necessarily. It all depends on a bunch of variables. You're right that a well designed and balanced system will deliver the right amount of air flow, but sometimes conditions outside the home/business, make it a necessity to get the ducts cleaned. As for mold? NO filter is going to address a mold issue. If you have mold, you have a moisture issue that needs to be addressed. Also, in my 38 years of experience in the HVAC and sheet metal industries, washable filters are one of the reasons ducts need to be cleaned. They are no where near efficient in cleaning/filtering the air to the level that they should.
The Antimicrobials Information Hotline provides answers to questions concerning current antimicrobial issues (disinfectants, fungicides, others) regulated by the pesticide law, rules and regulations. These cover interpretation laws, rules and regulations, and registration and re-registration of antimicrobial chemicals and products. The Hotline also provide information health & safety issues on registered antimicrobial products, product label and the proper and safe use of these antimicrobial products.
Most people are now aware that indoor air pollution is an issue of growing concern and increased visibility. Many companies are marketing products and services intended to improve the quality of your indoor air. You have probably seen an advertisement, received a coupon in the mail, or been approached directly by a company offering to clean your air ducts as a means of improving your home's indoor air quality. These services typically — but not always — range in cost from $450 to $1,000 per heating and cooling system, depending on:
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